109 articles - From Friday Mar 03 2023 to Friday Mar 10 2023
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Am J Gastroenterol |
ACG Clinical Guideline: Diagnosis and Management of Biliary Strictures. Recent evidence has provided some clarity in multiple important areas pertaining to biliary strictures, whereas several remaining controversies require additional research. The goal of this guideline is to provide practicing clinicians with the most evidence-based guidance on the approach to patients with extrahepatic and perihilar strictures, focusing on diagnosis and drainage. |
| Endoscopy |
Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review. ESGE recommends endoscopy/colonoscopy in the case of significant bleeding (hemodynamic instability, drop in hemoglobin > 2 g/dL, severe ongoing bleeding) to perform endoscopic hemostasis with thermal methods or clipping; hemostatic powders represent rescue therapies. ESGE recommends closure of immediate perforations with clips (through-the-scope or cap-mounted, depending on the size and shape of the perforation), as soon as possible but ideally after securing a good plane for further dissection. |
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
Randomised, placebo-controlled trial and meta-analysis show benefit of ondansetron for irritable bowel syndrome with diarrhoea: The TRITON trial. Although small numbers meant the primary endpoint was not met in this trial, when pooled with other similar trials meta-analysis suggests ondansetron improves stool consistency and reduces days with loose stool and urgency. |
| Clin Gastroenterol Hepatol |
Prevalence of non-alcoholic fatty liver disease in patients with rheumatoid arthritis: A systematic review and meta-analysis. Based upon this meta-analysis, one in three patients with RA had NAFLD, which appears comparable to its overall prevalence among general population. However, clinicians should actively screen for NAFLD in RA patients. |
| Gastrointest Endosc |
Long-term outcomes of local resection versus surgical resection for high-risk T1 colorectal cancer: A systematic review and meta-analysis. For high-risk T1 CRC patients, the net benefit of DSS appears to be significant when the observation period exceeds 10 years. A long-term net benefit may exist but may not be applicable to al patients, especially high-risk patients with comorbidities. Therefore, LR may be a reasonable alternative for individualized treatment for some high-risk T1 CRC patients. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
5-aminosalicylate maintenance is not superior to no maintenance in patients with newly diagnosed Crohn's disease-A nationwide cohort study. First-line 5-ASA monotherapy was not superior to no-MT but associated with a slightly higher rates of adverse events, while both strategies have declined over the years. These findings suggest that a subset of patients with mild CD may be offered a watchful waiting approach. |
Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma: Results from a German real-world cohort. Atezolizumab plus bevacizumab showed good efficacy and safety in patients with unresectable HCC and partially advanced liver cirrhosis in a real-world setting. Moreover, the NLR was able to predict response to atezolizumab/bevacizumab treatment and may guide patient selection. |
Clinical utility of urinary gluten immunogenic peptides in the follow-up of patients with coeliac disease. This study suggests that the frequency of recurrent gluten exposures, according to serial determination of u-GIP, could be related to the persistence of villous atrophy and that a more regular follow-up every 6 months, instead of annually, provides more useful data about the adequate adherence to GFD and mucosal healing. |
Longer time to recovery from acute kidney injury is associated with major adverse kidney events in patients with cirrhosis. Longer time to recovery is associated with an increased risk of MAKE in patients with cirrhosis and AKI. Further research should examine interventions to shorten AKI-recovery time and its impact on subsequent outcomes. |
Mitochondrial respiratory chain activity is associated with severity, corticosteroid response and prognosis of alcoholic hepatitis. Our results indicate that MRC activity is markedly decreased in the liver of AH patients, and, particularly, the impairment of MRC complexes I and III activity appears to have a significant impact on the clinical outcomes of patients with AH. |
Safety of an investigational formulation of budesonide (budesonide oral suspension) for eosinophilic oesophagitis: an integrated safety analysis of six phase 1-3 clinical trials. BOS was well-tolerated; most TEAEs with BOS were mild/moderate in severity. Clinicaltrials Gov numbers SHP621-101 (no clinical trials registration number), MPI 101-01 (NCT00762073), MPI 101-06 (NCT01642212), SHP621-301 (NCT02605837), SHP621-302 (NCT02736409) and SHP621-303 (NCT03245840). |
| Am J Gastroenterol |
Effectiveness of fenofibrate in treatment-naïve patients with primary biliary cholangitis: A Randomized Clinical Trial. In this randomized clinical trial in treatment-naïve patients with PBC, the combination of fenofibrate and UDCA resulted in a significantly higher biochemical response rate. Fenofibrate seemed to be well-tolerated in patients. |
Evaluation of computer aided detection during colonoscopy in the community (AI-SEE): a multicenter randomized clinical trial. Use of CADe did not result in a statistically significant difference in the number of adenomas detected. Additional studies are needed to better understand why some endoscopists derive substantial benefits from CADe and others do not. ClinicalTrials.gov number, NCT04555135. |
Increased Risk of Hospitalization, Surgery and Venous Thromboembolism Among Patients with Inflammatory Bowel Disease and Malnutrition in a Large, Community-Based Healthcare System. Malnutrition risk is significantly associated IBD-related hospitalization, surgery, and venous thromboembolism. Application of the MUST score to the EMR can efficiently identify patients at risk for malnutrition and adverse outcomes, permitting concentration of nutritional and non-nutritional resources to those at greatest risk. |
Personalized Antiviral Drug Selection in Chronic Hepatitis B Patients Using a Machine Learning Model: A Multinational Study. Considering the individual HCC risk predicted by PLAN-S and the potential TDF-related toxicities, TDF and ETV treatment may be recommended for the TDF-superior and TDF-nonsuperior groups, respectively. |
| Clin Gastroenterol Hepatol |
ENDOSCOPIC ULTRASOUND-GUIDED RADIOFREQUENCY ABLATION VERSUS SURGICAL RESECTION FOR TREATMENT OF PANCREATIC INSULINOMA. EUS-RFA is safer than surgery and highly effective for the treatment of PI. If confirmed in a randomized study, EUS-RFA treatment can become first line therapy for sporadic PI. |
| Endoscopy |
Endoscopic removal of lumen-apposing metal stents - risk factors for stent embedment, complex removals, and adverse events: analysis from a multicenter prospective case series. LAMS removal is a safe procedure, mostly requiring basic endoscopic techniques attainable in conventional endoscopy rooms. Referral to advanced endoscopy units should be considered for stents with known embedment or long indwell times, which may require more technically demanding procedures. |
| Gastroenterology |
A liquid biopsy signature for the early-detection of patients with gastric cancer. The low levels of this biomarker in post-surgery and other gastrointestinal tumor plasma samples indicated its GC-specificity. EV-derived GClnc1 serves as a circulating biomarker for the early detection of gastric cancer, thus providing opportunities for curative surgery and improved survival outcomes. |
A therapeutically targetable TAZ-TEAD2 pathway drives the growth of hepatocellular carcinoma via ANLN and KIF23. Therapeutic targeting of HCC, using pan-TEAD inhibitors or the combination of a statin with either sorafenib or anti-PD-1, decreased tumor growth. Our results suggest the cholesterol-TAZ-TEAD2-ANLN/KIF23 pathway as mediator of HCC proliferation and tumor cell-intrinsic therapeutic target that could be synergistically combined with TIME-targeted therapies. |
Artificial Intelligence enabled histological prediction of remission or activity and clinical outcomes in ulcerative colitis. We developed and validated an AI model that distinguishes histological remission/activity in biopsies of UC and predicts flare-ups. This can expedite, standardize and enhance histological assessment in practice and trials. |
Disruption of SLFN11 deficiency-induced CCL2 signaling and macrophage M2 polarization potentiates anti-PD-1 therapy efficacy in hepatocellular carcinoma. SLFN11 serves as a critical regulator of microenvironmental immune properties and an effective predictive biomarker of ICIs response in HCC. Blockade of CCL2/CCR2 signaling sensitized SLFN11 low HCC patients to ICI treatment. |
Factor analysis of the Rome IV criteria for major disorders of gut-brain interaction (DGBI) globally and across geographical, sex and age groups. The results indicate that the Rome IV criteria for IBS, functional dyspepsia, functional constipation, globus and biliary pain are globally valid and represent universal diagnostic entities that are similar across sex and age groups. |
Stiffness Restricts the Stemness of the Intestinal Stem Cells and Skews Their Differentiation Towards Goblet Cells. Collectively, our findings highlight that matrix stiffness potently regulates the stemness of ISCs and their differentiation trajectory, supporting the hypothesis that fibrosis-induced gut stiffening plays a direct role in epithelial remodeling in IBD. |
Surveillance for pancreatic cancer in high-risk individuals leads to improved outcomes: a propensity score-matched analysis. Surveillance for PDAC in carriers of a CDKN2A/p16 PV results in earlier detection, increased resectability and improved survival as compared to non-surveillance PDAC patients. |
| Gastrointest Endosc |
Novel Through-the-Scope Suture Closure of Colonic Endoscopic Mucosal Resection Defects. TTSS alone or with TTSC was effective in achieving complete closure of al post-EMR defects, despite a large lesion size. Following TTSS closure with or without adjunctive devices, delayed bleeding was seen in 3.2% of cases. Further prospective studies are needed to validate these findings before wider adoption of TTSS for large polypectomy closure. |
Prospective Randomized Comparison of Endoscopist-facilitated Endotracheal Intubation and Standard Intubation for ERCP. Endoscopist-facilitated intubation was technically successful in every patient. Median Endoscopist-facilitated intubation time from patient arrival in room to procedural start was 3.5-fold lower and median Endoscopist-facilitated intubation time was over 4-fold lower than for Standard intubation. Endoscopist-facilitated intubation significantly enhanced endoscopy unit efficiency and minimized staff and patient injury. General adoption of this novel approach may represent a paradigm shift in the approach to safe and efficient intubation of al patients requiring general anesthesia. While the results of this controlled trial are promising, larger studies in a broad population are needed to validate these findings. NCT03879720. |
| Gut |
Gnotobiotic mice housing conditions critically influence the phenotype associated with transfer of faecal microbiota in a context of obesity. These results suggest that the housing environment in which gnotobiotic mice are maintained post-FMT strongly influences gut microbiota composition and function and can lead to distinctive phenotypes in recipient mice. Better standardisation of FMT experiments is needed to ensure reproducible and translatable results. |
Interactive enhancer hubs (iHUBs) mediate transcriptional reprogramming and adaptive resistance in pancreatic cancer. Our findings identify an important role for a subgroup of highly connected enhancers (iHUBs) in regulating chemotherapy response and demonstrate targetability in sensitisation to chemotherapy. |
SK2 channels set a signalling hub bolstering CAF-triggered tumourigenic processes in pancreatic cancer. We establish a new paradigm in which an ion channel shifts the activation level of a signalling pathway in response to stromal cues, opening a new therapeutic window targeting the formation of ion channel-dependent signalling hubs. |
| Hepatology |
Alcohol-induced extracellular asc specks perpetuate liver inflammation and damage in alcoholic hepatitis even after alcohol cessation. Our study demonstrates the central role of NLRP3 and ASC in alcohol-induced liver inflammation and unravels the critical role of ex-ASC specks in the propagation of systemic and liver inflammation in AH. Our data also identify NLRP3 as a potential therapeutic target in AH. |
Gut microbiome-brain-cirrhosis axis. Clinical studies and animal models have demonstrated significant patterns of gut dysbiosis when cirrhosis is present, both with or without concomitant alcohol use disorder, and have provided compelling evidence that this dysbiosis also influences cognitive and mood-related behaviors. In this review, we have summarized the pathophysiological and cognitive effects associated with cirrhosis, links to cirrhosis-associated disruption of the gut microbiome, and the current evidence from clinical and pre-clinical studies for modulation of the gut microbiome as a treatment for cirrhosis and associated neuropsychiatric conditions. |
| J Hepatol |
Deregulated intracellular pathways define novel molecular targets for HBV-specific CD8 T cell reconstitution in chronic hepatitis B. Our study delineates a model of CD8 T cell exhaustion whereby multiple interconnected intracellular defects, including telomere shortening, are causally related to NAD depletion suggesting similarities between T cell exhaustion and cell senescence. Correction of these deregulated intracellular functions by NAD supplementation can also restore anti-viral CD8 T cell activity and thus represents a promising potential therapeutic strategy for chronic HBV infection. |
Interferon-induced IL-10 drives systemic T-cell dysfunction during chronic liver injury. Methods We combined BDL and CCl -induced prolonged liver injury is driven by sequential events involving microbial translocation, IFN signalling leading to myeloid cell-induced IL-10 expression, and IL-10-signaling in antigen-specific T-cells. Given the absence of immuno-pathology after interference with IL-10R, our study highlights a novel potential target to reconstitute T-cell immunity in CLD patients that can be explored in future clinical studies. |
Liquid biopsy-based protein biomarkers for risk prediction, early diagnosis and prognostication of cholangiocarcinoma. Serum EVs contain protein biomarkers for the prediction, early diagnosis and prognosis estimation of CCA detectable using total serum, representing a tumor cell-derived liquid biopsy tool for personalized medicine. Impact and implications The accuracy of current imaging tests and circulating tumor biomarkers for cholangiocarcinoma (CCA) diagnosis is far from satisfactory. Most CCAs are considered sporadic, although up to 20% of patients with primary sclerosing cholangitis (PSC) develop CCA during their lifetime, constituting a major cause of PSC-related death. This international study has proposed protein-based and etiology-related logistic models with predictive, diagnostic or prognostic capacities by combining 2-4 circulating protein biomarkers, moving a step forward into personalized medicine. These novel liquid biopsy tools may allow the i) easy and non-invasive diagnosis of sporadic CCAs, ii) identification of patients with PSC with higher risk for CCA development, iii) establishment of cost-effective surveillance programs for the early detection of CCA in high-risk populations (e.g., PSC), and iv) prognostic stratification of patients with CCA, which, altogether, may increase the number of cases eligible for potentially curative options or to receive more successful treatments, decreasing CCA-related mortality. |
TREM2+ macrophages suppress CD8+ T cell infiltration after transarterial chemoembolization in hepatocellular carcinoma. This study shows that TREM2 + TAMs play an important role in suppressing CD8 + T cells. TREM2 deficiency increased the therapeutic effect of anti-PD-L1 blockade by enhancing anti-tumor activity of CD8 + T cells. These findings explain the reasons for recurrence and progression after TACE and provide a new target for HCC immunotherapy intervention after TACE therapy. |
| Neurogastroenterol Motil |
Curricular representation of neurogastroenterology: A survey among medical students in Germany. Despite its epidemiological relevance, neurogastroenterology is only weakly represented in medical curricula. Students report low levels of subjective competence in handling NGDs. In general, assessing the learners' perspective on an empirical basis may enrichen the process of national standardization of medical school curricula. |
Epigenetic mechanisms underlying stress-induced visceral pain: Resilience versus vulnerability in a two-hit model of early life stress and chronic adult stress. The two-hit model of ELS followed by WAS in adulthood revealed that epigenetic dysregulation occurs after exposure to stress in two important periods of life and contributes to the development of visceral hypersensitivity. These aberrant underlying epigenetic changes may explain the exacerbation of stress-induced abdominal pain in IBS patients. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
Review article: Mechanisms underlying the effectiveness of exclusive enteral nutrition in Crohn's disease. The mechanisms of action of EEN are likely to involve a complex interplay between host mucosal immune response and luminal environment, but the identity of key factors remains poorly understood. A better definition of pathogenic factors may aid in developing more targeted dietary treatment and provide insights into the pathogenesis of Crohn's disease. |
| Clin Gastroenterol Hepatol |
The Evolving Profile of Idiosyncratic Drug Induced liver Injury. LiverTox is a comprehensive, freely accessible website with important information regarding the hepatotoxicity profile of over 1000 approved medications and 60 HDS products. Ongoing "omics" studies will hopefully lead to additional insight into DILI pathogenesis, improved diagnostic and prognostic biomarkers and mechanism-based treatments. |
| J Hepatol |
Fluid Resuscitation in Patients with Cirrhosis and Sepsis: A Multidisciplinary Perspective. Patients with advanced cirrhosis, sepsis and hypotension are less likely to be fluid responsive as compared to non-cirrhotic patients and early initiation of vasopressors is recommended. While norepinephrine is the first line option, the role of terlipressin needs to be clarified in this context. |
Primary sclerosing cholangitis and overlap features of autoimmune hepatitis: a coming of age or an age-ist problem? Thus, we argue that it is now time to align disease names and descriptions used by clinicians across al patient subpopulations, to help care become uniform and ageless. This will enhance collaborative studies and contribute ultimately to rational treatment advances. |
Role of immune responses for development of NAFLD-associated liver cancer and prospects for therapeutic modulation. Here, we provide an overview of NASH-related inflammation/pathogenesis focusing on new discoveries on the role of T cells in NASH-immunopathology and therapy response. This review discusses preventive measures to halt disease progression to liver cancer and therapeutic strategies to manage NASH-HCC patients. |
The exposome and liver disease - how environmental factors affect liver health. Exposomics is poised to play a major role in the field of liver pathology. Methodological advances such as the exposomics-metabolomics framework, genomics and epigenomics signatures of risk factors and cross-species biological pathway analysis should further delineate the impact of the exposome on the liver and open the way for improved prevention, new biomarkers of exposure and effects, and additional targets for therapies. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
Letters to the editors and authors’ replies
| Clin Gastroenterol Hepatol |
| Gut |
| J Hepatol |